PTSD & Spiral Steroids

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event.  Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. The diagnosis is based solely on psychiatric symptoms. Many patients also have endocrine features, including lack of REM sleep, hypertension, and a poor response to dexamethasone-suppressed ACTH challenge.  These symptoms have been considered as sporadic independent features. In this concept paper, we propose that these features are not independent, but are all part of a self-reinforcing endocrine cycle. Ionotropin has a critical role in the cycle. An understanding of the cycle suggests several new potential therapies for PTSD and, potentially, a new insight into essential hypertension.         

 Schematic Description of the Cycle

                  Green arrows connect processes that are increased in patients with PTSD. Red arrows connect processes that are decreased in patients with PTSD. The black arrow marks a process whose relationship to PTSD is not yet known. The block in GH secretion could be at either part of the hypothalamic-pituitary axis.

Chasalow F, Blethen S. New Concept: Endocrine Dysfunction in Post-Traumatic Stress Disorder (PTSD): The Role of Ionotropin. EC Paediatrics 8.10 (2019):1104-1110. doi: 10.31080/ecpe.2019.08.00560.